Healthcare Provider Details

I. General information

NPI: 1063393502
Provider Name (Legal Business Name): REALTALK WITH NEXTSTEP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 LINWOOD DR STE B
PARAGOULD AR
72450-5365
US

IV. Provider business mailing address

1707 LINWOOD DR STE B
PARAGOULD AR
72450-5365
US

V. Phone/Fax

Practice location:
  • Phone: 870-604-4455
  • Fax: 888-977-2956
Mailing address:
  • Phone: 870-604-4455
  • Fax: 888-977-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: HEATHER MCQUAY
Title or Position: DIRECTOR OF ACCOUNTS
Credential: MSHCM
Phone: 870-604-4455